Example: ExplanationOfBenefit-explanationofbenefit-pbs-example-02

Formats: Narrative,XML, JSON, Turtle

Raw json

{
  "resourceType" : "ExplanationOfBenefit",
  "id" : "explanationofbenefit-pbs-example-02",
  "meta" : {
    "profile" : [
      "http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/explanationofbenefit-medicare"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: explanationofbenefit-pbs-example-02</p><p><b>meta</b>: </p><p><b>contained</b>: , , </p><p><b>identifier</b>: urn:oid:2.25.129844986816735724544008039950138526110</p><p><b>type</b>: Pharmacy <span style="background: LightGoldenRodYellow">(Details : {http://hl7.org/fhir/ex-claimtype code 'pharmacy' = 'Pharmacy)</span></p><p><b>subType</b>: pbs <span style="background: LightGoldenRodYellow">(Details : {https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1 code 'pbs' = 'pbs)</span></p><p><b>patient</b>: </p><p><b>created</b>: 16/01/2017</p><p><b>prescription</b>: unknown resource contained</p><h3>Items</h3><table class="grid"><tr><td>-</td><td><b>Sequence</b></td><td><b>Service</b></td><td><b>Serviced[x]</b></td></tr><tr><td>*</td><td>1</td><td>cephalexin 500 mg capsule, 20 <span style="background: LightGoldenRodYellow">(Details : {urn:oid:1.2.36.1.2001.1005.22 code '03119E' = '03119E', given as 'cephalexin 500 mg capsule, 20'})</span></td><td>16/01/2017</td></tr></table></div>"
  },
  "contained" : [
    {
      "resourceType" : "Organization",
      "id" : "Organization2",
      "identifier" : [
        {
          "system" : "http://pbs.gov.au/code/manufacturer",
          "value" : "MM"
        }
      ]
    },
    {
      "resourceType" : "Medication",
      "id" : "Medication2",
      "code" : {
        "coding" : [
          {
            "system" : "urn:oid:1.2.36.1.2001.1005.22",
            "code" : "03119E"
          }
        ]
      },
      "manufacturer" : {
        "reference" : "#Organization2"
      }
    },
    {
      "resourceType" : "MedicationRequest",
      "id" : "MedicationRequest2",
      "meta" : {
        "profile" : [
          "http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs"
        ]
      },
      "status" : "active",
      "intent" : "order",
      "medicationReference" : {
        "reference" : "#Medication2"
      },
      "subject" : {
        "identifier" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/v2/0203",
                "code" : "NI",
                "display" : "National unique individual identifier"
              }
            ]
          },
          "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
          "value" : "8003608166690503"
        }
      },
      "authoredOn" : "2017-01-15",
      "dispenseRequest" : {
        "quantity" : {
          "value" : 100,
          "unit" : "tablet"
        }
      }
    }
  ],
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.25.129844986816735724544008039950138526110"
    }
  ],
  "type" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/ex-claimtype",
        "code" : "pharmacy"
      }
    ]
  },
  "subType" : [
    {
      "coding" : [
        {
          "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
          "code" : "pbs"
        }
      ]
    }
  ],
  "patient" : {
    "identifier" : {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/v2/0203",
            "code" : "NI",
            "display" : "National unique individual identifier"
          }
        ]
      },
      "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
      "value" : "8003608166690503"
    }
  },
  "created" : "2017-01-16",
  "prescription" : {
    "reference" : "#MedicationRequest2"
  },
  "item" : [
    {
      "sequence" : 1,
      "service" : {
        "coding" : [
          {
            "system" : "urn:oid:1.2.36.1.2001.1005.22",
            "code" : "03119E",
            "display" : "cephalexin 500 mg capsule, 20"
          }
        ]
      },
      "servicedDate" : "2017-01-16"
    }
  ]
}